Dorsolateral prefrontal cortex stimulation modulates electrocortical measures of visual attention: Evidence from direct bilateral epidural cortical stimulation in treatment-resistant mood disorder

G. Hajcak, B. S. Anderson, A. Arana, J. Borckardt, I. Takacs, M. S. George, Z. Nahas

Research output: Contribution to journalArticlepeer-review

34 Scopus citations


Electrocortical activity is increasingly being used to study emotion regulation and the impact of cognitive control on neural response to visual stimuli. In the current study, we used direct epidural cortical stimulation (EpCS) to examine regional specificity of PFC stimulation on the parietally-maximal late positive potential (LPP), an event-related potential (ERP) biomarker of visual attention to salient stimuli. Five patients with treatment-resistant mood disorders were stereotactically implanted with stimulating paddles over frontopolar (FP) and dorsolateral (DL) prefrontal cortex bilaterally. On their first day of activation, patients underwent sham-controlled EpCS coupled with 64-channel electroencephalograph (EEG) recordings and passive viewing of aversive and neutral images. In addition to sham, patients had either FP or DL prefrontal cortex stimulated at 2 or 4 V while they viewed neutral and aversive pictures. As expected during the sham condition, LPP was larger for aversive compared to neutral stimuli (F(1,4)=232.07, P<001). Stimulation of DL compared to FP prefrontal cortex resulted in a reduction of the LPP (F(1,4)=8.15, P=.048). These data provide additional and unique support to the role of the DL prefrontal cortex in regulating measures of neural activity that have been linked to emotional arousal and attention. Future studies with EpCS can help directly map out various prefrontal functions in treatment-resistant mood disorder.

Original languageEnglish (US)
Pages (from-to)281-288
Number of pages8
Issue number1
StatePublished - Sep 2010

Bibliographical note

Funding Information:
Disclosures: Dr. Nahas reports having received consulting fees from Neuronetics Inc. and Cyberonics Inc; research funding from National Institute of Mental Health (NIMH ), National Alliance of Research for Schizophrenia and Depression , Hope for Depression Research , Neuronetics Inc , Cyberonics Inc ., Medtronic Inc . (in form of device donations for this study), Brainsway and Integra . Dr. Hajcak receives research funding from the NIMH . Dr. George reports research funding from Glaxo-Smith Kline , Jazz , NIMH , NIDA , NINDS , and the Ralph H. Johnson VA Medical Center . Dr. George reported consulting for Bristol-Meyers-Squibb, DarPharma, GlaxoSmithKline, Jazz Pharmaceuticals, Parke Davis, Aspect Medical, Brainsway, Brainsonix (unpaid), Cephos (unpaid), Cyberonics, Inc, Dantex, Mediphysics/Amersham, Neuronetics Inc (unpaid) and Neuropace. Dr. George also reported that MUSC has filed eight patents or invention disclosures under his name regarding brain imaging and brain stimulation. Dr. Borckardt receives research funding from the National Institute for Neurological Disorders and Stroke and the National Institute of Nursing Research at NIH , Cyberonics Inc , the Neurosciences Institute at MUSC . Dr. Borckardt is a consultant for Neuropace. Dr. Anderson and Ms. Arana reported no biomedical financial interests or potential conflicts of interest.

Funding Information:
Study funded primarily by a National Alliance of Research for Depression and Schizophrenia (NARSAD) Independent Investigator Award to ZN. Study was also made possible with general funds from the Mood Disorders Program , the Brain Stimulation Laboratory , the General Clinical Research Center (GCRC), the Center for Advanced Imaging Research (CAIR) at the Medical University of South Carolina. Medtronic Inc. (Minneapolis, Minnesota) donated the devices but was otherwise not involved in the study, particularly data acquisition, analysis, or drafting this manuscript. The authors would like to thank Mark Rise (Medtronic Inc.) for technical assistance in stimulation set ups.


  • Attention
  • Brain stimulation
  • IAPS
  • Late positive potential


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